Risk of Nonspine Fractures in Older Adults with Sarcopenia, Low Bone Mass, or Both.
Risk of Nonspine Fractures in Older Adults with Sarcopenia, Low Bone Mass, or Both.
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DOI：
10.1111/jgs.13605
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发表时间：
2015-09
影响因子：
6.3
通讯作者：
Osteoporotic Fractures in Men Study Research Group
中科院分区：
文献类型：
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作者：
Chalhoub D;Cawthon PM;Ensrud KE;Stefanick ML;Kado DM;Boudreau R;Greenspan S;Newman AB;Zmuda J;Orwoll ES;Cauley JA;Osteoporotic Fractures in Men Study Research Group
为了验证这一假设，即患有低骨密度和肌肉减少症的男性和女性比只有一种或两种情况都没有的人骨折的风险更高。男性骨质疏松性骨折研究和女性骨质疏松性骨折研究是前瞻性观察性研究，平均随访时间分别为9年（2000-2012）和8年（1997-2009）。美国临床中心5，544例男性（平均年龄=73.7岁）和1，114例女性（平均年龄=77.6岁）;年龄均≥ 65岁;能够在无辅助的情况下行走，无需双侧髋关节置换术。肌肉减少症被定义为低的非正式瘦体重加上缓慢或虚弱;以及低骨密度，根据世界卫生组织的T评分<-1.0的定义。参与者被分为正常骨密度和无肌肉减少症（N=3367名男性，308名女性）;仅肌肉减少症（N=79名男性; 48名女性）;仅低骨密度（N=1986名男性; 626名女性）和低骨密度和肌肉减少症（N=112名男性; 132名女性）。与骨密度正常且无肌肉减少症的男性相比，骨折的风险比[HR]为3.79（95%置信区间[CI]，2.65-5.41）在低骨密度和肌肉减少症的男性中，1.67（95%CI，1.45-1.93），仅肌肉减少症男性为1.14（95%CI，0.62-2.09）。与正常女性相比，低骨密度和肌肉减少症（HR，2.27; 95%CI，1.37-3.76）的女性和仅低骨密度的女性（HR，2.62; 95%CI，1.74-3.95），但仅肌肉减少症的女性骨折风险增加。同时具有低骨矿物质密度和肌肉减少症的男性骨折的风险特别高。
To test the hypothesis that men and women with both low bone mineral density and sarcopenia have a higher risk of fracture than those with only one or neither conditions. The Osteoporotic Fractures in Men study and the Study of Osteoporotic Fractures in women are prospective observational studies with a mean follow up of 9 years (2000–2012) and 8years (1997–2009) respectively. US clinical centers 5,544 men (mean age=73.7 years) and 1,114 women (mean age=77.6 years); all ≥age 65; able to walk without assistance, and without bilateral hip replacement. Sarcopenia was defined as low appendicular lean mass plus either slowness or weakness; and low bone mineral density, by the World Health Organization definition of T-score<−1.0. Participants were classified as normal bone mineral density and no sarcopenia (N=3367 men, 308 women); sarcopenic only (N=79 men; 48 women); low bone mineral density only (N=1986 men; 626 women), and low bone mineral density and sarcopenic (N=112 men; 132 women). Compared to men with normal bone mineral density and no sarcopenia, the Hazard ratio [HR] for fracture was 3.79 (95% confidence interval [CI], 2.65–5.41) among men with low bone mineral density and sarcopenia, 1.67 (95% CI, 1.45–1.93) among men with low bone mineral density only, and 1.14 (95% CI, 0.62–2.09) among men with sarcopenia only. Women with low bone mineral density and sarcopenia (HR, 2.27; 95% CI, 1.37–3.76), and women with low bone mineral density alone (HR, 2.62; 95% CI, 1.74–3.95), but not women with only sarcopenia had increased risk of fracture compared to normal women. Men with both low bone mineral density and sarcopenia are at especially high risk of fracture.